Milwaukee shoulder

Case contributed by Dr Suraindra Mark Rajadurai

Presentation

Chronic shoulder pain.

Patient Data

Age: 75 years
Gender: Female
X-ray

Extensive bony destruction and remodeling, intra-articular loose bodies, large effusion and soft tissue swelling. 

Ultrasound guided aspiration

Ultrasound

Ultrasound demonstrated a complete supraspinatus tear as well as a large amount of joint fluid. This was aspirated and sent for cytology.

Intra-articular betamethasone and bupivacaine were then injected under aseptic technique. 

Case Discussion

This is a classic appearance of Milwaukee shoulder. The patient had a longstanding history of chronic pain and deformity. She presented for symptomatic treatment with ultrasound guided aspiration and intra-articular steroid injection.

On ultrasound there was a complete supraspinatus tear and a large effusion, aspiration yielded pale blood stained fluid which demonstrated hydroxyapatite crystals on cytology.

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